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HomeMy WebLinkAboutRobinson (2) iieLL 'az U-vv �� Town Hall, 53095 Main Road ���' P.O. Box 1179 Southold, New York 11971 ,i FAX(516)765-1823 JUDITH T.TERRY �r TOWN CLERK %��i��` TELEPHONE(516)765-1801 REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 1319-R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X New Existing X Name Of Owner ROB I NSON, ELLEN Mailing Address 1 P. O. BOX 264 Mailing Address 2 City St Zip MATTITUCK NY 11952-0000 Property Address 1 OREGON ROAD Property Address 2 City St Zip MATTITUCK NY 11952-0000 Owner Telephone No. 516-298-4828 Tax Map No. section 1 .00 block 2 lot 4 Cross Street ELIJAHS LANE Date Of Last Pump Out 12/21/88 Issue Date: 11/27/89 Judith T. Terry Southold Town Clerk (TOWN SEAL) OFFICE OF THE TOWN CLERK cWFD1,�C� Town of Southold •;-��� ' Application No. Judith T. Terry, Town Clerk ..2 ' 4 ', T .l Town Hall, 53095 Main Road $10.00 - Residential P. O. Box 1179 $25.00 - Non-Residential Southold, New York 11971 O '® '�'" • • Telephone 01 `% (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. Fee $ • DATE ayzy7g? OWNER NAME: R6 101 a �� • OWNER MAILING ADDRESS: / y O. b6 k .aC cif Mg.H f4 /14 71 y -� OWNER PROPERTY ADDRESS: -8r-r—,01.1. ✓ iitt OWNER TELEPHONE NUMBER: r/ — � �/ �- y TAX MAP NO. : Section 100 Block 2.. Lot Al CROSS STREET: c , a/11-()_, TYPE OF SYSTEM: Septic Tank New Existing Cesspool 1,/ New Existing 1.7- Residential Residential V Non-Residential DATE OF PREVIOUS PUMP-OUT: � V9S" LOCATION MAP: Must be attached hereto before permit may be issued. (Locate building and system; give north arrow and feet of distance, approximately, to building and closest road.) Signature of Applicant RECEIVED BY: Town Clerk's Office DATE: 0 ` . . ` , ^ --'- ---- - --- --- - ---'-- - -- . _ —_ __ —'--'- _----_--_ �~ �� 1� �� �� �. � a / . � �—�N��^ � ° � . � e� ,� � ~ �� ^ --- -'--- — �� ���k tz c _- __ _-__ ��t�o�w�� _��,~` ���� � ���� ��� _---'- __��b��-��]L������ w� .v `-__� " v ' _ __ �\ --_-_ - V ___ __II41 __- ___- -- iver„241-,,, �-' _ --_ - �=��-� _______~�� - '-__' . . - _---_ o � � , , ~ - d __ --- ` ov;Qc,..me . �������� ����� ��� �� ��� �� � � �� � . ` oW '-- --- 1 \__L _____4 ;4 : .:.„, f:‘'7 c‘,,,)vif-'-' - -__- ` � ] r . 1 ____________ __ __ __][ ekf�� I----- ' -- -- --G- V� /-- - - VO f1 / \ ^� ' 7 ' . _ 1 _ - -- _ __ . '^- -- \----' -- -- --- - /Y\ 11r- - ---- 1------ / �. --___ --__-,- ~a / � _-- I -_ \ � --_ _-_ -_� __---_-_ ~ . ` ^'' -- -- ` - ---- ------- !-�_�n "��_'_.-_ ° -_--'_ - - - -' - , . _ _ _ _____ ____ __ - - '� i_--_'_--------- ---- -----------'------� - v � . -- --- � ' ~- ,' -7 _-_ '__-__-_-'- __--_.- ` - - _ ~__---__ -- / '� . _ ___ _______ - ' . -----________ ____ - ------ ---- _ __ _ ___ ____ __ ___ _